Effect of tumor load on energy expenditure in patients with pancreatic cancer.

Pancreas. 2012 Mar;41(2):230-2..
Vaisman N, Lusthaus M, Niv E, Santo E, Shacham-Shmueli E, Geva R, Figer A.

OBJECTIVE: Increased metabolic rate may play a role in cancer cachexia,
especially when caloric intake is significantly reduced. We studied the effect of
tumor load on resting energy expenditure (REE) in patients with pancreatic cancer
after normalizing for their daily caloric intake and body composition.
METHODS: The cross-sectional study included 45 patients with pancreatic cancer
(15 postoperation) and 75 controls. Resting energy expenditure was measured by
indirect calorimetry, body composition was measured by dual-energy x-ray
absorptiometry, and energy intake was measured by 3-day food records.
RESULTS: There were no differences between pancreatic cancer patients who
underwent surgery and those who did not in any of the anthropometric or metabolic
parameters tested. Body mass index, lean body mass, body fat percentage, and
energy intake were significantly lower in patients with pancreatic cancer (P <
0.0001) compared with healthy controls. Resting energy expenditure and the
respiratory quotient were significantly lower in patients (P < 0.0001 and P <
0.025, respectively). There were no differences in REE between patients and
controls when normalized by lean body mass. Respiratory quotients were
significantly lower in patients who underwent surgery and in those who did not
compared with controls.
CONCLUSIONS: Pancreatic cancer does not increase REE above the normal levels nor
does tumor burden contribute to increasing REE. Decreased daily energy intake of
our patients may have reduced measured REE.